Fracture splint



R. ANDERSON FRACTURE SPLINT Dec. 14, 1937;

Filed Dec. 15, 1934 VIII/ll Poss/ HNDEPON I BY j v TIL ATTORNEY into thebone.

Patented Dec. 14, 1937 FRACTURE SPLINT Roger. Anderson, Seattle, Wash.,assignor to 'l he Tower Company, Seattle, Wash, a corporation ofWashington Application December 15, 1934, Serial No. 757,641

13 Claims.

This invention relates to improvements in splints designed for thereduction of fractures in the bones of the arms and legs of the humanbody, and it has reference more particularly to splints of thatcharacter wherein reduction is effected by a direct attachment of thesplint to the fractured bone; the present invention being in the natureof an improvement on the splint described and illustrated in myco-pending application, filed on August 29, 1933 under Serial No.687,263, wherein a frame structure mounts two traction yokes in spacedrelation and in position to receive the fractured limb therein andwherein traction pins are mounted by the yokes to be extended throughthe bone at opposite sides of the fracture so that by a relativeadjustmerit of the yokes, the fractured parts may be brought into properalinement and traction may be applied to reduce the fracture and holdthe bones properly for application of a cast thereto. When the cast isapplied, the ends of the pins are embedded therein and then after thecast has set, the limb may be removed from the splint and by reason ofthe solidity and rigidity of the cast, the pins will hold the bones inproper relationship against the tension of muscles.

In many instances, however, it is more desirable to use small wires inlieu of the pins, as this ,lessens the danger of infection; they aremore easily applied and require only relatively small holes through thebone. However, when wires are used, they must of necessity be keptabsolutely taut or otherwise they will cut into the bone with seriousresults.

When wires are used with the yokes of that type of the device shown inthe co-pending application above mentioned, the special wire tighteningclamps, associated with the yokes, are employed to draw and retain thewires taut. The limb cannot with satisfaction be removed from the yokes,for the reason that no means has been provided to retain them taut.Simply the embedding of the ends of the wires in the cast will not keepthem suificiently taut to avoid cutting Should the patient attemptperambulation with these large yokes still attached, he would experienceconsiderable difficulty due to their size.

In view of the fact that use of wires is desirable, and in order thatperambulation of the patient may be provided as soon as possible, theprincipal object of this invention has been to provide an improved formof splint, adapted to the use of traction wires in lieu of pins, andincluding wire tauteners of novel character associated with the tractionyokes for mounting the traction wires and for maintaining them taut.Also, to provide means for mounting the tauteners in the traction yokesfor the application of tractive forces necessary to the reduction andsetting of the fracture.

It is also an object to provide mounting trunnions for the tautenerswhich provide for pivotal adjustment in the yokes without change inrelative position of the wires, and located coaxially of the axis ofrotation of their mounting trunnions. 7 Other objects of the inventionreside in the details of construction and in the combination of parts,as will'hereinafterbe described.

Fig. 1 is a perspective view of a splint embodying the improvements ofthe present invention; showing, in dotted lines, the application of alimb thereto.

Fig. 2 is a sectional detail of the yoke mounting and adjusting means.

Fig. 3 is an elevation of one of the traction yokes with a wire mountingtauteners applied thereto and indicating the application of the wire toa limb.

Fig. 4 is an enlarged view of the wire mounting tautener, a part beingbroken away for better illustration.

Fig. 5 is a view showing the wire holding clamp plate and illustratingthe slotting of the Wire seating trunnion of the tautener.

Fig. 6 is a front view of the same parts.

Fig. 7 is a section taken on line 66 in Fig. 6.

Fig. 8 is an alternative arrangement'wherein the tautener is outside thetraction yoke.

Referring more in detail to the drawing In a preferred form ofconstruction, the present splint comprises a base frame structure havingopposite end cross bars I and 2, rigidly joined in spaced relation bytwo pairs of longitudinal rods 3-3 and 3a3a. These pairs of rods are 7parallel and also the rods in each pair are parallel and verticallyspaced. This base frame, for practical purposes, would be madeapproximately two feet long and seven inches wide, but if desired, maybe made in other dimensions, to suit any particular use to which it isto be put.

Supported transversely of the base frame is a cross bar 4 which, at itsends, is slidably mounted on the longitudinal rods and is adjustablealong the frame by means of a threaded shaft 5. Thisshaftyat one end,extends revolubly through a. hole in the end bar I and at its other end,is threaded through a depending lug T on the under side of the cross bar4. At the outer end of the shaft 5 is a hand wheel 8 by means of whichit may be rotated thereby. to shift the cross bar 4 to differentpositions.

Mounted upon the cross bar 2 at one end of the frame and upon the crossbar 4 are yoke mounting bases [2. Each of these is; provided on itsunder side, as seen in Fig. 2, with a vertical pivot l3 revolubly fittedin a socket M in the cross baron which it rests. Each base I2 is alsoformed with a iiange l5 overlying a central, lateral extension [6 of itssupporting bar and in the flange of each base is a slot ll formedarcuately about the axis of the corresponding pivot l3. Bolts l8 extendthrough the slots I? and are threaded into the parts [6 of the base barsto hold the bases at different positions of a pivotal adjustment. Eachbase 12 also is provided with spaced vertical flanges 29-20 betweenwhich the traction yokes 2i are mounted. These flanges snugly receivethe base portions of the traction yokes between them and retain theyokes rigidly in upright position, but permit of lateral rotativeadjustment therein.

Each of the yokes 2| is of U-shape and its .base portion 2la is curvedradially about a center point located at the intersection of theextended axis of the pivot I3 and a line between the ends of the yokearms. The under edge of the yoke base is formed with gear teeth 25 thatmesh with those of an adjusting gear wheel 25 mounted between theflanges of the yoke sup porting base and fixed on a rotatably mountedshaft 21 extended through the flanges and equipped at one end with ahand wheel 28. A pin 29 extended through the flanges 20 just above theyoke base, holds the yoke ,in place.

In the device of the application previously mentioned, the ends of theyoke arms were equipped to mount the opposite ends of the traction pinsor wires. In the present instance, wires are employed but they aremounted in frames known in trade as tauteners which in turn areremovably mounted in the traction yokes. One of the tauteners is wellillustrated in Fig. 4 wherein 30 designates a longitudinally channeledbase bar in which a pair of lever arms 3l3l are pivotally mountedrespectively at opposite ends of the bar by pivots 3232. These levershave inner end portions 3 la extended into overlapped relation at alocation medially of the bar and they have outer end portions 3lbextended in substantially parallel relation for mounting therebetweenthe traction wire 35.

As will be observed in Fig. 4, the inner end portion 3la of one of thelever arms underlies the other and these ends have rounded interengagingportions. Also there is an adjusting bolt 36 threaded through the baseof the bar 30 and engaging with the end of the underlying arm 3la. Aleaf spring 38 is mounted at the opposite side of the two arms by a pin39 extended through the bar and this spring has its opposite endportions bearing inwardly against the arms, 3Ia3la.

Assuming that the ends of a wire 35 are mounted and flxed in the outerends of the lever arms, it is apparent that it may be put under tensionand held taut by adjusting the bolt 36 inwardly, thereby to rock thelever arms on their pivots in a manner to spread their outer ends. Whenthe bolt is outwardly adjusted, the spring 38 causes the arms to movetoward each other to release their tension on the wire.

For mounting the frames or tauteners, the arms 3lb-3lb are provided attheir ends with pivots or trunnions 42-42, located in axial alinementwith each other and adapted to seat revolubly within upwardly openingtransverse channels 43 in the upper ends of the opposite arms of a yoke2!. The construction provides that the tauteners may swing pivotallyabout the supporting trunnions to different positions as is indicated inFig. l. g

It will be observed, by reference to Fig. 7, that the trunnion 42 ismounted in the arm M2) by a threaded shank 44 of considerably lesserdiameter. It is also observed that the trunnion has a longitudinal slot50 for seating the end of the traction wire therein, and this slot isextended into the trunnion to a depth which provides that the wire, whenseated, will be coaxial of the trunnion and will rest flatly against aface of the arm 3"). This arrangement provides that when the tautener ismounted in the arms of a yoke, asshown in Fig. 1, they may be rotatablyadjusted, and will not cause any change in relative positions of thewire which they mount; it being understood that if the axis of a wirewas eccentric of the axial line of the trunnions of a tautener it wouldchange position with rotation of the tautener and this, although verylittle, might throw the fractured bones out of proper setting. v I

When the ends of a wire are applied to the trunnion slots, as in Fig. 5,they seat flatly against the arms 3lb. They are then clamped and held byclamp plates 55 arranged to be tightened against them by bolts 56, asseen in Fig. 5.

As shown in Fig. 3, the tautener is generally located inside the arms ofthe traction yoke 2|, but it is understood that it might be made so thatits arms are outside the yoke arms, as shown in Fig. 8; thisnecessitating locating the trunnions at the inside of the arms 3Ib.

Assuming the device to be so constructed, it is used as follows: First,the bone is prepared at opposite sides of the fracture to receive thetraction wires 35 therethrough. After the wires have been extendedthrough the bone the opposite ends of each is applied to the oppositearms of a tautener and are clamped beneath the clamp plates, as shown inFigs. 5, 6 and '7. Then the bolt 3a: of the tautener is adjustedinwardly to. place the wire under the proper and required tension. Thetrunnions of the tauteners are then seated within the sockets at theends of the arms ofl traction yokes 2|, as shown in Fig. 3, and theyokes are then adjusted by manipulation of the hand wheel 28 and bypivotal movement about the pivots l3 "and by application of traction byadjusting screw 5 to bring the end portions of the fractured bone intoproper relationship. Then a plaster cast is applied about the limb andthe tautening yokes are embedded in the cast. After the cast has set,the limb may then be lifted from the traction yokes and perambulation ofthe patient is thereby provided for.

If at any later time it would be desired to remove the cast from thelimb for treatment of the latter, the limb is again applied to thesplint, the trunnions of the tauteners are replaced within the socketsof the! traction yokes and the latter are set against movement. Then thecast may be removed-from the limb without any danger of the bonesshifting or changing their relationship. After a new cast has beenapplied and has set solidly about the tauteners, the latter may again beremoved from the traction yokes to permit perambulation.

In this form of device, the tautening yokes are so reduced in size andWeight that they do not interfere with perambulation of the patient.They retain the traction wires taut at all times so that cutting of thebone thereby cannot occur. The particular advantage of this type ofdevice resides in the fact that the tautening yokes are relativelysmall; they may be easily and. quickly"" applied to the traction yokes;they provide a satisfactory and effective means of holding the wiresunder tension and also afford a means of solidly anchoring the wires inthe cast. Another advantage in the construction is that the wires arelocated coaxial of the trunnions, thereby permitting rotative adjustmentof the tauteners in the traction yokes without effecting any change inrelationship of the traction wires.

Having thus described my invention, what I claim as new therein anddesire to secure by Letters Patent is-- 1. In a fracture reducingsplint, a traction yoke, a. traction wire for transfixing a limb, a wiretautener frame for embracing the transfixed limb, and including meansfor gripping opposite end portions of the wire, and an adjusting meansfor spreading the frame to tension the wire, pivot means mounting theframe in the yoke for application of traction to the limb and permittingrotation of the frame about the axial line of the taut wire.

2. In a splint having a traction frame a traction wire, a wire mountingtautener adapted to embrace a limb and including means for grippingopposite end portions of the wire after it has been projected through alimb, and for holding the wire under tension, and trunnions coaxial ofthe wire for mounting the tautener frame in the traction frame forrotative movement about the axial line of the trunnions and wire.

3. In a splint, in combination, two relatively adjustable tractionapplying supports adapted to receive a limb for treatment, tractionwires corresponding to the supports, a Wire tautener frame associatedwith each support for embracing the limb, and comprising means forgripping opposite end portions of its corresponding traction wire afterthe latter has been projected through the limb and adjustable to placeand hold the wire under tension, and means on each tautener forremovably mounting it in its corresponding support and whereby it may berotated about the axial line of the wire.

4. A fracture splint comprising a base, a pair of traction applyingyokes mounted thereon for receiving a limb to be treated, means foreffecting a change in spacing and a relative rotative adjustment of theyokes about the anatomical axis of the limb, a frame associated witheach yoke and adapted to embrace the limb, a wire mounted by each frameand held under tension thereby; said wires being adapted to transfix thelimb at opposite sides of a fracture, and trunnions on said frameswhereby they are rotatably mounted in the yokes.

5. A device as in claim 4 wherein said trunnions of each frame are inaxial alinement with the wire mounted by said frame.

6. In a splint of the character described, a wire tautener comprising abase member, a pair of bell cranks pivotally mounted thereon withcorresponding arms extended in spaced relation and their other armsextended into interengaged relation whereby tautening movement of onecauses a like movement of the other, a wire fixed at its ends to thefirst mentioned arms and an adjustment member adjustably mounted in thebase and operatively engaging one of the interengaged arms, and trunnionsupports for the tautener extended from the first mentioned arms coaxialof the wire.

7. In a splint of the character described, a traction applying means, awire mounting frame comprising a base bar, a pair of bell crankspivotally mounted thereon having corresponding arms extended from thebar in spaced relation, and their other arms interengaged for effectingadjustment in spacing of the first mentioned arms, an adjustment meansin the bar for actuating the interengaged arms to effect an adjustmentin spacing of the first mentioned arms, means on the extended arms formounting a traction wire between them, a traction wire mounted by saidmeans, and supports on the said frame coaxial of the wire adapted tomount the frame rotatably in the traction applying means.

8. A device as recited in claim 7 wherein said frame supports are in theform of trunnions removably applied to said traction applying means and,providing for rotative mounting of the frame in the traction applyingmeans.

9. A device as in claim 7 wherein the said frame supports are in theform of trunnions that extend from the first mentioned arms of the bellcranks coaxial of the traction wire extended between them, and arelongitudinally slotted to receive the wire coaxially therein.

10. In a splint, in combination, a traction element having spaced armswith end slots, a wire mounting frame for embracing a limb, a tractionwire, means on said frame for gripping opposite ends of the tractionwire after it has transfixed the limb embraced by the frame, means foradjusting the frame to effect the tensioning of the gripped wire,trunnions on the frame axially alined with the taut wire and pivotallyseated in the end slots of said spaced arms for application of tractionto the limb; said pivots being adapted to be unseated from the armswithout loss of tension on the wire.

11. In a splint of the character described, a support, a yoke mountingbase having a mounting pivot applied to the support, a traction yoke ofU-shape, adjustably mounted in said yoke mounting base in the axialplane of the said mounting pivot and rotatably adjustable about a centerin the extended axial line of the said mounting pivot, a'wire tautenerframe comprising spaced arms provided with trunnions supported by thearms of the traction yoke and a wire mounted under tension by said frameand extending between the spaced arms and passing through said center.

12. The combination with a traction applying means for embracing a limb,of a wire mounting frame adapted to be mounted removably within saidtraction means and having spaced arms for securing the opposite ends ofa wire for transfixing the limb, and means in the frame for adjustingthe relationship of said arms to regulate the tension of the wire.

13. In a fracture splint, a traction applying yoke, means supportingsaid yoke for rotation about the anatomical axis of a limb appliedthereto, a. wire mounting frame supported by the yoke, between the armsthereof, and a wire mounted under tension by said frame, for transfixingthe limb through its anatomical axis; said wire mounting frame beingmounted by said yoke for rotation about the axial line of the wire.

ROGER ANDERSON,

